Statement by the Undergraduate Teaching
Leads Forum
November 2011 /
Students’ experience of different specialties during their medical training greatly influences their subsequent career choice. We all know this anecdotally but now it is also substantiated through evidence. Just maintaining the current rates of 4-5% of recruitment into psychiatry would result in a shortage of psychiatrists and downgrading of services for people with mental health disorders. It is therefore a priority for all of us in the profession to do everything we can to increase recruitment. Those who are involved in any way with medical student teaching are in a strong position to make a difference and there are many opportunities. Studies have shown that some of the reasons why students don’t choose psychiatry are because they think it is not scientific enough, has low public standing, is stressful and depressing and psychiatric patients are perceived as being dangerous and untreatable. We can address all of these false perceptions through our teaching. On the other hand, students choose psychiatry because they encounter psychiatrists who are charismatic, inspiring, caring and enjoy their work and we need to provide these positive role models. Enthusing students about our profession can be achieved through several approaches:
Recognize the importance of undergraduate education in recruitment
· The first place to start is within our own organization. The Undergraduate Teaching Leads Forum was initiated by the RCPsych Academic Faculty and comprises representatives from every medical school in the UK. It is the only official group representing those who are responsible for delivering psychiatry education in our medical schools. At present the Forum is a subgroup of the Academic Faculty and has limited resources to carry out its mandate to raise the standard of every aspect of undergraduate psychiatry education in the UK and therefore needs the support and recognition of the whole College. The Forum has identified improving recruitment into psychiatry as one of its main aims and it should play a prominent role in the College’s recruitment programme.
· We need to raise and maintain a very high profile for psychiatry within each medical school and university in the UK – this is the job of each medical lead and their position is strengthened by being supported by the Forum and College rolling out educational initiatives and maintaining standards. For example: some schools are beginning to say they don’t need a psychiatry lead and this needs to be challenged.
· Academic departments and Trusts need to recognize the key role of education and make sure that there is time in job planning and setting priorities.
Deliver a high standard of teaching in psychiatry
What to teach?
· Provide and maintain a high standard of psychiatry teaching in the medical curriculum
· Psychiatry should be integrated as early as possible in the course – trying to recruit in the 4th or 5th year can be to late and attitudes are already set
· Include a strong scientific basis with teaching from senior academics and scientists – if you don’t have these available in your institution use recorded videos (to be made available by the Forum in their sharing of resources initiative (about to go live soon).
· If you do have excellent speakers record their presentations and share them.
· Integrate Psychiatry into the curriculum as widely and as early as possible, teaching jointly with basic science and other specialties: eg delirium with neuroscience, depression in endocrinology, child psychiatry with paediatrics etc
· Have a clear national curriculum in psychiatry that is constantly reviewed and updated (latest version just completed by Forum and to be released shortly)
· Disseminate it from the College and support the work needed to update it
How to teach?
· Early contact with clinical psychiatrists – don’t leave it to others to teach psychiatry and psychiatry clinical skills. Get the students in contact with us to see that psychiatrists are not “all mad.”
· Make sure that lectures are given by experts who know how to give lectures
· Support your clinical teachers and provide them with appropriate training
· Get the trainees involved in teaching and supervise and train them to teach
· Maintaining high standards with student evaluation, peer assessment, clearly defined outcomes and standards
· Skills workshops and small interactive group teaching favoured by students
· In clinical placements only have the best teachers and welcoming teams – if someone is disillusioned help them all you can but don’t send the students there: being made to feel welcome is constantly cited by students as being extremely important.
· Address the fear some students have about being on a psychiatry unit and the fact that some students will have problems with psychiatry because of personal or family experience of mental illness.
· Seeing a variety of patients including patients who have responded to treatment and are doing well. Include patients and service users in teaching.
· The importance of positive role modeling cannot be overstressed– some consultants are not happy with their jobs and freely express this to students. While we don’t want to present a false picture of psychiatry, it is not a good idea to send students to placements with these people where this may not be their only exposure to psychiatry.
· Include senior academics in teaching and provide cutting edge material
· SSCs are an excellent way of providing a wide variety of teaching for interested students
· Intercalated degrees with mental health projects
· Awarding certificates of merit and prizes at medical school and at the RCPsych level.
· Involvement of students in conferences and meetings presenting posters and research.
Improving the image of psychiatry and psychiatrists
· Involve patients who are doing well to give hope of recovery and demonstrate good outcome. Examples: high functioning user with schizophrenia involved in small group discussions, focus on “whole patient journey” rather than just florid signs.
· Liaison psychiatry is a particularly effective “shop window of psychiatry”
· Some medical schools have introduction to all clinical specialties, important to include psychiatry in this type of teaching.
· Challenge the negative material on the Internet eg Scientologists, disgruntled patient groups and address the need to be discerning about what is valid source.
· Create more positive material to put out on internet to redress balance (current Forum initiative)
· Psychiatrists need to seen leading on psychiatry teaching and having a prominent role in education at their medical school – support those teaching by appropriate job planning, honorary academic posts, promotion and excellence awards for teaching
· Positive role modelling at every opportunity
· Challenge those who “bad mouth” psychiatry
Maintaining the enthusiasm
· Mentorship programmes – maintains continuity with role models and make this flexible – particularly useful if started early in course
· Buddy system with CT trainees making direct contact with students and supporting them in their interest in psychiatry throughout the course
· Special interest in psychiatry and student psychiatric societies – widen scope with topics to welcome students not necessarily interested in psychiatry.
· Link psych groups with other interest groups e.g. neuroscience and others for more exposure
· Summer Schools (National Summer School Initiative led by Forum) – excellent experience from those held (including Sheffield – recruited more trainees than ever, Liverpool, Cardiff, Kings)
· Represent psychiatry at every opportunity – Freshers Fair, Careers programmes etc
· Set up Prizes, include students in conferences, award bursaries to students to attend conferences
· Student associate programme at RCPsych
· Involvement in medical school and hospital grand rounds
· Film societies and festivals
· Schools programme in which students visit schools to raise awareness of mental health issues and in turn recruit interested students to medical school and psychiatry
Ania Korszun
Chair, Undergraduate Teaching Leads Forum,
Academic Faculty, RCPsych